| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 | 4500 TOWN CENTER BOULEVARD SUITE 200 JEFFERSONVILLE, IN 47130 | ANTHEM HEALTH PLANS OF KENTUCKY INC | $29K | $81 | $29K | 2.45% |
| ASSUREDPARTNERS3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $2K | $11K | 11.73% |
| PAYCOM PAYROLL LLC5 Filed as: PAYCOM PAYROLL, LLC | 7501 WEST MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $4K | $4K | 3.87% |
| ASSUREDPARTNERS3 | 2305 RIVER ROAD LOUISVILLE, KY 40206 | DELTA DENTAL OF KENTUCKY | $4K | $0 | $4K | 8.89% |
| ASSUREDPARTNERS3 | 5905 EAST GALBRAITH ROAD SUITE 5000 CINCINNATI, OH 45236 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | $0 | $5K | 12.10% |
| SRA INSURANCE AGENCY LLC3 Filed as: SRA INSURANCE AGENCY, LLC | 4435 MAIN STREET, 4TH FLOOR KANSAS CITY, MO 64111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 4.76% |
| MARY CARMELA BERARDI3 Filed as: MARY C. BERARDI | 3617 BEATEN PATH LEXINGTON, KY 40509 | CONTINENTAL AMERICAN INSURANCE COMPANY | $952 | $0 | $952 | 2.18% |
| TYLER A DECKER3 Filed as: TYLER A. DECKER | 4325 COBBLESTONE KNOLL DRIVE LEXINGTON, KY 40515 | CONTINENTAL AMERICAN INSURANCE COMPANY | $952 | $0 | $952 | 2.18% |
| LAWRENCE TODD FUGATE3 Filed as: LAWRENCE T. FUGATE | 2443 SIR BARTON WAY, SUITE 400 LEXINGTON, KY 40509 | CONTINENTAL AMERICAN INSURANCE COMPANY | $632 | $0 | $632 | 1.45% |
| HEATHER L MAMMEN3 Filed as: HEATHER L. MAMMEN | 468 BOB O. LINK DRIVE LEXINGTON, KY 40503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $632 | $0 | $632 | 1.45% |
| AP BENEFIT ADVISORS, LLC3 | 200 INTERNATIONAL CIRCLE SUITE 4500 HUNT VALLEY, MD 21030 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | $0 | $31 | 0.07% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM HEALTH PLANS OF KENTUCKY INC | 193 | $1.2M |
| Dental | DELTA DENTAL OF KENTUCKY | 136 | $44K |
| Vision | ANTHEM HEALTH PLANS OF KENTUCKY INC | 193 | $1.2M |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $98K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $98K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $98K |
| Prescription drug | ANTHEM HEALTH PLANS OF KENTUCKY INC | 193 | $1.2M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $141K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 193 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.